Brătucu E, Lazar Am, Marincaş M, Daha C, Zurac S
University of Medicine and Pharmacy "Carol Davila", Department of Surgery I, Bucharest Oncology Institute "Al. Trestioreanu", Bucharest, Romania.
Chirurgia (Bucur). 2013 Mar-Apr;108(2):152-60.
Mesenteric lymphadenitis constitutes a frequent cause for abdominal pain and may manifest acute abdominal symptoms. Very often, it is difficult to achieve a differential diagnosis as there are many diseases that can generate mesenteric lymphadenopathy. Many times, it is impossible to determine the diagnosis of the disease that has triggered mesenteric lymphadenopathy even after surgical intervention with biopsy. The failure in determining the precise cause of the mesenteric lymphadenoapathy, as well as its unresponsiveness to conservative treatments increases the difficulty in the management of this disease very much. In this paper we have reviewed the diseases that can trigger mesenteric lymphadenitis in detail, with reference to our experience. To the best of our knowledge, this is the most extensive review on this theme in current specific literature. The case reported by us, with a history of mesenteric adenitis, splenic and ganglionic abscesses, vasculitis skin nodules, pseudotumoral ileal stenosis and remission-recurrence pattern over 25 years, has raised extremely difficult problems of differential diagnosis. Its enlistment as a Crohn's disease, vasculitis or aseptic abscess syndrome seems unsatisfactory. The analysis of the data in this case can raise the legitimacy of the question: should we recognize and define a new entity?
肠系膜淋巴结炎是引起腹痛的常见原因，可表现为急性腹部症状。通常，由于有许多疾病可导致肠系膜淋巴结病，因此很难进行鉴别诊断。很多时候，即使在进行活检的手术干预后，也无法确定引发肠系膜淋巴结病的疾病诊断。无法确定肠系膜淋巴结病的确切病因，以及其对保守治疗无反应，这大大增加了该疾病的治疗难度。在本文中，我们结合自身经验，详细回顾了可引发肠系膜淋巴结炎的疾病。据我们所知，这是当前特定文献中关于该主题最全面的综述。我们报告的病例有肠系膜腺炎、脾脏和神经节脓肿、血管炎皮肤结节、假瘤性回肠狭窄病史，且病程长达25年，呈现缓解-复发模式，引发了极其困难的鉴别诊断问题。将其归为克罗恩病、血管炎或无菌性脓肿综合征似乎都不尽人意。对该病例数据的分析可能会引发这样一个问题的合理性：我们是否应该认识并定义一个新的实体？
